SCHOOL MANAGEMENT OF

EPILEPSY
DR. AJERO J.A
MBBS
 INTRODUCTION
 What is Epilepsy?
• Epilepsy is a chronic condition of recurrent
and unprovoked seizure.
• An individual is considered to have epilepsy
when he/she has atleast two unprovoked
seizures occuring more than 24 hours apart.
• it is a sign of underlying brain dysfunction.
• The term epileptic seizure can be used or its
simply called seizure.
 INTRODUCTION
 what is seizure?
• seizure is a paroxysmal (a sudden recurrence or intensification of symptoms)
involutary alteration of brain function caused by abnormal discharge
of neurons in the brain.
note: convulsion is an abnormal involuntary contraction of the
muscles. often used as a synonym for seizure, but not all seizures are
convulsive in nature.
seizure may manifest as an impairment or loss of consciousness,
abnormal motor activity, behavioural abnormalities, sensory
disturbances(tingling,light flashes), or autonomic dysfunction (like
sweating, epigastric rushing sensation), hallucinations and illusions.
 EPIDEMIOLOGY
• Epilepsy is the commonest chronic neurologic disorder in children
• Affects about 10.5 million children worldwide. Majority are found
amongst the low socioeconomic class in the developing countries.
• The highest incidence is in the first year of life (100 per 100,000
children).
• Associated with a lot of social stigma and diverse cultural beliefs
as to its causation and treatment.
• Majority are curable with early and appropriate management.
 PATHOPHYSIOLOGY
• It is a paroxysmal manifestations of the electrical
properties of the brain
• A group of neurons generate a significat burst of
discharge to initiate a seizure
• this is dependent on excitatory glutamate synapses.
• seizures may arise even in areas of dead neurons which
promote development of hyperexcitable synapses.
• A seizure results when a sudden imbalance occurs
between the excitatory and inhibitory forces within the
network of neurons in favour of a sudden-onset net
excitation. This balance maybe disrupted by genetic or
acquired factors.
• the clinical manifestations of seizures depend on the
part of the brain involved in the seizure activity.
 CAUSES OF EPILESY
Any factor that disturbs brain function may cause seizures.
• Idiopathic (cause unkown or presumed to be genetic).
• Neurologic insults - birth asphyxia, intracranial
hemorrhage, central nervous system infections, head
trauma, intracranial injuries, etc.
• Congenital brain malformation.
note: The above mentioned causes are not the only
causes of epileptic seizures, there are many more.
 SCHOOL MANAGEMENT OF SEIZURE
The following are general important key note in the
management and First Aid for seizure espcially in an
environment which is not a health center or hospital:
• Do not panic, stay calm and remain with the person,
and reassure other people who may be nearby.
• The immediate environment where the person is
should be cleared of any dangerous objects
immediately, so as to prevent the person from injury.
• Place he/she in the left lateral postion to avoid
aspiration.
• Ease the person to the floor and put something soft and
flat, like a folded jacket, under his head.
• Remove eyeglasses and loosen ties or anything around
the neck that may make breathing difficult.
• Do not hold the person down or try to stop his
movements.
• Do not try to put any thing in the person’s mouth. Like
trying to use spoon for the teeth, trying to use any sort of
liquid or fluid inside the mouth. This may lead to aspiration
and immediate death.
• Stay with the person until the seizure ends naturally and
he is fully awake.
• Time the seizure with your watch. If the seizure continues
for longer than five minutes without signs of slowing
down, or if a person has trouble breathing afterwards,
appears to be injured, in pain, or recovery is unusual in
some way, the person should be rushed to the nearest
clinic for help.
• For a schools that have a proper well equipped sick-bay
with trained health personnels, the seizure can be aborted
using Intramuscular Paraldehyde or Intravenous/Rectal
diazepam. After which the person can be taken to a
health facility for proper evaluations.
• Call and inform child’s parents afterwards.
 HELPING STUDENTS WITH SEIZURES
• It is important to find out students (from their parents) who are epileptic and are
on medications before accepting as a student in the school.
• Understanding the importance of medication adherence and supporting
students who take daily medications is important.
• Helping students to avoid seizure triggers, or triggers identified in the Seizure
Action Plan.
• A seizure action plan contains the essential information school staff may need
to know in order to help a student who has a seizure. It includes information on
first aid (of which we have discussed above), parents and health care provider
contacts, and medications specifically for that child.
• Seizure Action Plans are an important tool that help parents and schools partner
to keep children safe and healthy during the school day.
• educate the students on the need not to make fun of or stigmatise any student
with epilepsy.
educate the students on the need not to make
fun of or stigmatise any student with epilepsy.
 Epilepsy Myths/ False Beliefs
• If someone is having a seizure, you should put
something into their mouth. using spoon to prevent the
teeth from coming together
• Giving urine, oil to the child.
• You should restrain someone having a seizure.
Fact: never hold down a person during a seizure. Holding
someone down can cause a bone or muscular injury.
instead, make sure the surrounding area is clear of objects
and their head is padded with something soft.
• Epilepsy is contagious
Fact: You are not able to catch epilepsy from another
person.
• It is also thought to be due to witchcraft.
• It is considered as due to a demoniac possession.
 An Algorithma child
showing the proper first aid
having seizure?

for a school management of epilepsy

Do not panic, stay calm and
remain with the person

Place he/she in the left Ease the person to the floor

clear the surroundings
lateral postion to avoid and put something soft and
of any dangerous aspiration. flat, like a folded jacket,
object to present injury under his head.
 loosen ties or
anything around
the neck that may
make breathing
difficult.

Do not hold the

person down
or try to stop
his movements.

Do not try to
put any thing in
the person’s
mouth
Stay with the person
until the seizure ends
naturally and he is
fully awake.
 Time the seizure with your watch.

If the seizure continues for longer than five

minutes without signs of slowing down.

For a schools that have a proper well Call and inform child’s
equipped sick-bay with trained parents afterwards, so that
the person should be rushed to the
health personnels, the seizure can be
nearest clinic for help. child can be taken to a health
aborted using IM Paraldehyde or
IV/Rectal diazepam. facility for proper
evaluations.
 CONCLUSION
• In our society today,epilepsy is associated with a lot of
social stigma and diverse cultural beliefs as to its
causation and treatment. It is our responsiblity as health
workers to help school staff and school pupils to
understand what epilepsy really is, and to help give a
proper first aid management, and also to help educate the
students on the need not to make fun of or stigmatise any
student with epilepsy.
References
• Igwe WC. (2017,) A Handbook of paediatric Epilepsy And
Febrile Seizures Patrobas Nig Ltd, Vol.1, pp 62
• cdc.gov/healthyschools
• ung.edu
• medicalnewstoday.com/article/medical-myths-about-
epilepsy
THANK
YOU